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Experience with mandibular reconstruction using transport-disc-distraction osteogenesis.

Lorena Pingarrón-Martín1, T González Otero2, L J Arias Gallo3

  • 1Department of Oral and Maxillofacial Surgery, University Hospital Rey Juan Carlos, Madrid, Spain.

Craniomaxillofacial Trauma & Reconstruction
|May 23, 2015
PubMed
Summary

Transport-disc-distraction osteogenesis (TDDO) offers a viable alternative for severe mandibular defects, restoring bone continuity with reduced morbidity. This technique shows promise for complex reconstructions, including dental implants and orthognathic surgery.

Keywords:
TDDOameloblastomagunshot injurymandibular reconstructiontransport-disc-distraction osteogenesis

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Regenerative Medicine
  • Biomaterials Engineering

Background:

  • Severe mandibular defects pose reconstructive challenges, often requiring invasive procedures.
  • Conventional methods may have donor site limitations or prolonged surgical times.
  • Transport-disc-distraction osteogenesis (TDDO) utilizes in-situ bone for reconstruction.

Purpose of the Study:

  • To evaluate the efficacy of TDDO in mandibular reconstruction.
  • To report the first use of TDDO combined with dental implants and orthognathic surgery.
  • To analyze outcomes in patients with severe segmental mandibular defects.

Main Methods:

  • Retrospective analysis of mandibular reconstruction cases suitable for distraction (2006-2011).
  • Inclusion of eight cases: six ameloblastomas, two gunshot fractures (defect size 45-60 mm).
  • Protocol: 5-day latency, 19-45 day activation (avg. 30 days), 8-12 week consolidation.

Main Results:

  • Mean distraction length achieved was 40.45 mm.
  • TDDO facilitated bone regeneration and soft tissue provision.
  • Reduced donor-site morbidity compared to traditional approaches.

Conclusions:

  • TDDO is a valuable alternative for severe segmental mandibular defects.
  • It enables anatomical bone regeneration and functional restoration.
  • Patient education is crucial for optimizing outcomes with distraction devices.